First Time Looking Into Group Health
You have never offered benefits and you want to know what it involves before you commit to anything — what a group plan actually is, what you would decide, and what it would do to payroll.
Small-Business Group Health — Licensed in 9 States — Independent Broker
Two kinds of employer end up here: the one offering health benefits for the first time and trying to work out what it would cost, and the one who just opened a renewal that went up and wants to know whether that number is normal. We do the same work either way.
Where are you starting from?
Shopping Your Group Health Renewal
You already offer a plan and the renewal went up. You want a second opinion from someone who can take your group to more than one carrier and tell you honestly whether the increase is worth moving over.
What goes on a benefits package
Group health is what most employers come for. The other four are what a package usually ends up including, and they cost far less than the medical line.
The one everybody asks about first
Group Health Insurance
Medical cover for your employees and usually their families. It is the biggest line on the benefits bill and the one people leave jobs over.
Cheap to add, loudly missed when absent
Group Dental Insurance
Cleanings, fillings, and the bigger work. Employees notice dental far out of proportion to what it costs to put on the plan.
Exams, frames and lenses
Group Vision Insurance
The smallest line on the package and an easy yes. It also catches conditions that show up in an eye exam before anywhere else.
When someone cannot work for a while
Group Disability Insurance
Short and long term. It replaces part of an income when illness or injury stops a paycheck, which is the risk most employees have not priced.
A benefit nobody wants to use
Group Life Insurance
A flat amount payable to whoever an employee names. It is inexpensive on a group basis and it is a real reason people stay.
What an independent broker changes
A carrier’s representative can show you that carrier’s plans. That is not a criticism of them — it is the job. We are appointed with several carriers, so the same group goes to all of them and you see what each one says side by side.
It also changes who you call later. When a claim is handled badly, or an employee cannot find a doctor who takes the plan, you call us rather than a queue. We are paid the same whichever carrier you choose, which is what makes it possible for us to tell you that the plan you already have is the right one.
If this is your first time
A group health plan is one contract between your business and a carrier, covering the employees who enroll. You choose the plan, you choose how much of the cost you cover, and your employees decide whether to take it.
The part that confuses people is the contribution. You are not expected to pay all of it. You set a share for the employee and often a different share for family members; carriers require you to cover at least some of the employee’s cost for the group to qualify, and above that it is your call. That single decision drives both what the plan costs you and how many of your team actually sign up — which is why it is the first thing we work through rather than the last.
If you are shopping a renewal
A renewal increase is one carrier’s opinion of your group for the coming year. It is not a market price and it is not final. We take the same group to the other carriers we are appointed with and bring back what they say.
Moving is not automatically the answer. Changing carriers can change the network your employees use, and a cheaper plan that drops their doctor is not cheaper in any way that matters to them. We compare the whole thing — what it costs, who is in network, and how the plan behaves when somebody is actually ill — and then tell you which is better, including when that is the plan you already have.
Where we are licensed
Group health is regulated state by state, so where your employees are matters as much as where the business is registered.
- Indiana
- Tennessee
- South Carolina
- Florida
- Illinois
- Ohio
- Kentucky
- Colorado
- Texas
Questions employers ask us
How small can a business be and still offer a group health plan?
Smaller than most owners assume. Group plans are built for businesses with employees on payroll, and the threshold is lower than the number people usually have in mind. What matters more than the headcount is that the people on the plan are genuine employees rather than contractors, and that enough of them take it up. Tell us your situation and we will tell you plainly whether a group plan is available to you.
Do I have to pay for all of it?
No. The employer picks a contribution — a share of the cost for the employee, and often a different share for family members. Carriers set a minimum the employer has to cover for the group to qualify, and above that it is your decision. The contribution you choose is the main lever you control, and it is the one we walk through first, because it drives both your budget and how many people actually enroll.
My renewal came in higher. Is that normal, and can I do anything about it?
An increase at renewal is common and it is not the end of the conversation. The number your current carrier sends is one carrier’s answer, and it is shoppable. We take the same group to the other markets we are appointed with and see what they say. Sometimes the answer is that your existing plan is still the best available and you should keep it — we would rather tell you that than move you for the sake of it.
What does an independent broker actually do that my carrier does not?
A carrier can only offer you its own plans. We are appointed with several, so we take your group to all of them and compare what comes back — the premium, yes, but also the network your employees would be using and how the plan behaves when someone is actually ill. We are paid the same either way, which is what lets us tell you when the answer is to stay put.
Will my employees be able to keep their doctors?
That depends on the network, and it is worth checking before you choose rather than after. Each plan has a list of doctors and hospitals it treats as in-network, and the same insurer often sells several networks of different sizes. If there is a particular doctor or hospital your team cares about, tell us at the start and we will check it against the options rather than finding out at the first appointment.
How long does it take to put a plan in place?
Less time than the paperwork suggests, provided we start before your intended effective date rather than on it. The sequence is: we gather the basics about your group, market it to the carriers, bring you the options, you choose and set your contribution, then your employees enroll. The part that tends to slow things down is enrollment, because it needs a response from every employee, so we start that early.
What happens when an employee turns 65?
They become eligible for Medicare, and they do not automatically have to leave your plan. Whether your group plan or Medicare pays first depends on the size of your business, and the rules are specific enough that guessing is a bad idea. This is a question to ask us before the birthday rather than after it, and it is one we handle regularly for employers of this size.
Which states can you write in?
We are licensed for accident and health in 9 states: Indiana, Tennessee, South Carolina, Florida, Illinois, Ohio, Kentucky, Colorado, Texas. Group health is regulated state by state, so where your employees live matters as much as where your business is registered. If you have people in a state we are not licensed in, say so at the start — it changes what we can do and we would rather raise it than discover it late.
Who we are, and how we help
Wexford Health Insurance is a brand of Wexford Insurance, LLC , an independent agency in Greenwood, Indiana, licensed for accident and health in 9 states. Independent means we are not one carrier’s sales channel — we bring the market to you, and you keep the relationship with us when it renews.
We hold appointments with 9+ health carriers, and the 9 quoting small-group business today are: Anthem, UnitedHealthcare, Allied National, Optimyl Benefits, Nationwide Health, Cigna, Aetna, Kaiser Permanente, and Humana. Which of them can write your plan depends on the state you are in and the size of your group — that is a question we answer for your business, not one this page can answer for everyone. The list is reviewed quarterly and changes when a carrier’s appetite does.
Most of the owners I talk to are not trying to buy the cheapest plan. They are trying to work out whether they can promise something and still afford it next year. That is a different question, and it is the one worth answering carefully.
Wexford Insurance, LLC is a licensed independent insurance agency, NPN 19887690. You can verify our licensing at NIPR.com.
Tell us about your group
A licensed broker reads every submission and comes back with what the markets will actually do for an employer your size — including when the answer is to leave your plan alone.